NDM-1- and OXA-23-producing in wastewater of a Nigerian hospital.

is a leading cause of hospital-associated infections globally. reservoirs outside hospital settings are still unknown, and their occurrence in the environment is linked to clinical and anthropogenic activities. Although the risk of transmission of from environmental sources to humans is not fully understood, these sources pose significant risks for the continued dissemination of and their resistance traits. This study provides evidence that diverse and clinically relevant strains, many of which are resistant to carbapenems, are constantly being discharged into the environment through inadequately treated hospital wastewater. We further elucidate potential transmission routes between the environment and clinical infections and demonstrate the high prevalence of carbapenem resistance genes on highly mobile transposons among these strains. Our findings highlight the pressing need to address hospital wastewater as a crucial factor in curtailing the spread of carbapenem-resistant .